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The family of a client in hospice asks about stopping oral feedings. The nurse should explain that:
- A. Stopping feedings may reduce discomfort.
- B. Feedings must continue to prevent starvation.
- C. Oral feedings are required by law.
- D. Stopping feedings will hasten death.
Correct Answer: A
Rationale: Stopping oral feedings in hospice can reduce discomfort from fluid overload or aspiration, aligning with comfort-focused care.
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Which of the following is a priority outcome for the client with Addison's disease?
- A. Maintenance of medication compliance.
- B. Adherence to a 2-g sodium diet.
- C. Prevention of hypertensive episodes.
- D. Demonstration of effective coping skills.
Correct Answer: A
Rationale: Medication compliance is critical in Addison's disease to prevent adrenal crisis and maintain hormonal balance.
A client is admitted with a 6.5-cm thoracic aneurysm. The nurse records fi ndings from the initial assessment in the client’s chart, as shown below. At 10:30 a.m., the client complains of sharp midchest pain after having a bowel movement. What should the nurse do first?
- A. Assess the client’s vital signs.
- B. Administer a bolus of lactated Ringer’s solution.
- C. Assess the client’s neurologic status.
- D. Contact the physician.
Correct Answer: A
Rationale: The size of the thoracic aneurysm is rather large, so the nurse should anticipate rupture. A sudden incidence of pain may indicate leakage or rupture. The blood pressure and heart rate will provide useful information in assessing for hypovolemic shock. The nurse needs more data before initiating other interventions. After assessment of vital signs, neurologic status, and pain, the nurse can then contact the physician. Administering lactated Ringer’s solution would require a physician’s order
Sublingual nitroglycerin tablets begin to work within 1 to 2 minutes. How should the nurse instruct the client to use the drug when chest pain occurs?
- A. Take one tablet every 2 to 5 minutes until the pain stops.
- B. Take one tablet and rest for 10 minutes. Call the physician if pain persists after 10 minutes.
- C. Take one tablet, then an additional tablet every 5 minutes for a total of three tablets. Call the physician if pain persists after three tablets.
- D. Take one tablet. If pain persists after 5 minutes, take two tablets. If pain still persists 5 minutes later, call the physician.
Correct Answer: C
Rationale: Standard protocol for sublingual nitroglycerin is one tablet every 5 minutes for up to three doses. If pain persists, the client should seek medical help.
A female receiving radiation therapy for lung cancer complains to the nurse that she is having difficulty sleeping. Which of the following nursing actions is most appropriate?
- A. Suggest the client stop watching television before bed.
- B. Assess the client's usual sleep patterns, amount of sleep, and bedtime rituals.
- C. Tell the client sleeplessness is expected with radiation therapy.
- D. Suggest that the client stop drinking coffee until the therapy is completed.
Correct Answer: B
Rationale: Assessing sleep patterns, amount of sleep, and bedtime rituals provides a comprehensive understanding of the client's insomnia, enabling tailored interventions.
A client on hemodialysis reports muscle cramps. The nurse should:
- A. Increase dialysate flow.
- B. Check electrolyte levels.
- C. Administer a diuretic.
- D. Encourage ambulation.
Correct Answer: B
Rationale: Muscle cramps may indicate electrolyte imbalances, requiring lab assessment.